Alcohol intolerance can cause immediate, unpleasant reactions after you consume alcohol. The most common signs and symptoms of alcohol intolerance are nasal congestion and skin flushing. This condition is sometimes inaccurately referred to as an alcohol allergy. Alcohol intolerance is caused by a genetic condition in which the body is unable to break down alcohol. The only way to prevent alcohol intolerance is to avoid alcohol altogether.
In some cases, what may seem to be alcohol intolerance is caused by a reaction to something else in an alcoholic beverage — such as chemicals, grains or preservatives. In other cases, reactions are caused by combining alcohol with certain medications. In rare instances, reactions to alcohol can be a sign of a serious underlying health problem that requires diagnosis and treatment.
Alcohol intolerance symptoms — or symptoms of a reaction to ingredients in an alcoholic beverage — can include:
You may not need to see a doctor if you have a mild intolerance to alcohol or something else in alcoholic beverages. You may simply need to avoid alcohol, limit how much you drink or avoid certain types of alcoholic beverages that seem to be causing your symptoms. However, if you have a serious reaction or you suspect your symptoms could be linked to an allergy or underlying health problem or a medication you’re taking, see your doctor.
Alcohol intolerance occurs when your body doesn’t have the proper enzymes to break down (metabolize) the toxins in alcohol. This is caused by inherited (genetic) traits.
Intolerance reactions can also be caused by a number of other ingredients commonly found in alcoholic beverages, especially in beer or wine. These include:
In some cases, reactions can be triggered by an allergy to a grain such as corn, wheat or rye or to another substance contained in alcoholic beverages.
Rarely, severe pain after drinking alcohol is a sign of a more serious underlying disorder, such as Hodgkin lymphoma.
Risk factors for alcohol intolerance or other reactions to alcoholic beverages include:
Depending on the cause, complications of alcohol intolerance or other reactions to alcoholic beverages can include:
Although alcohol intolerance usually isn’t a serious issue, you may want to discuss it with your doctor at your next appointment. Because appointments can be brief, it’s a good idea to prepare ahead of time. Here’s some information to help you get ready for your appointment, and what to expect from your doctor.
Don’t hesitate to ask questions during your appointment any time that you don’t understand something.
Being ready to answer your doctor’s questions can save time to go over any points you want to spend more time on. Your doctor may ask:
What you can do in the meantime
Avoid the beverage or beverages that seem to cause your reaction until your doctor’s appointment. If you do drink an alcoholic beverage that causes a mild reaction, over-the-counter antihistamines may help relieve symptoms. If you have a more severe reaction — such as a severe skin reaction, weak pulse, vomiting or trouble breathing — seek emergency help right away.
Your doctor will try to figure out whether you have an intolerance, or if your symptoms are caused by something else, such as a reaction to other ingredients in alcoholic beverages. The following may help determine the cause of your symptoms:
The only way to avoid alcohol intolerance symptoms or an allergic reaction is to avoid alcohol or the particular beverage or ingredients that cause the problem. For a minor reaction, over-the-counter or prescription antihistamines may help reduce symptoms, such as itching or hives. However, antihistamines can’t treat a serious allergic reaction.
If you’ve had a severe allergic reaction to a certain food, wear a medical alert bracelet or necklace that lets others know that you have an allergy in case you have a reaction and you’re unable to communicate. Ask your doctor if you need to carry emergency epinephrine (adrenaline) in the form of an autoinjector (EpiPen, Twinject). This prescription device has a concealed needle that injects a single dose of epinephrine when you press it against your thigh.
Unfortunately, no medications or other treatments can prevent reactions to alcohol or other ingredients in alcoholic beverages. The only way to avoid a reaction is to avoid alcohol completely or avoid whatever particular substance causes your reaction. Read beverage labels carefully to see whether they contain ingredients or additives you know cause a reaction, such as sulfites or certain grains. But, be aware that labels may not list the ingredient or ingredients that cause your reaction.
The key treatment is to do your best to avoid the beverage in question. Work with your doctor to identify what steps you can take to relieve your symptoms and how to spot and respond to a severe reaction.